Rachael's leadership story

Dr Rachael Moses OBE is a Consultant Respiratory Physiotherapist and former BTS President.

On becoming a leader

In my earlier years, I thought the only way to develop leadership skills was to undertake courses, but not being academically driven, I put off applying for formal leadership training.  That was until a conversation with a very wise mentor at the time who encouraged me to think about leadership development through experiential learning, so this is the route I decided to take.

Having been blessed with exceptional managers who displayed great leadership attributes, I had also been exposed to managers who were dismissive, divisive and controlling, which I found really demoralising.   I quickly realised you could learn just as much from the people you didn’t want to become as the people you aspired to be, and this sparked my interest in human behaviours and the effects they can have on others.

Rather than formal training, I decided to apply for positions of responsibility where I would be surrounded by diverse leaders in my field of critical care and respiratory medicine. This would mean organising and speaking at conferences and study days, and, of course, joining the BTS initially as a member and then on committees and council.  It was really having the opportunity to listen and learn from others who had what I considered good leadership attributes, and if I could see those attributes in myself while I progressed in my career. 

Leadership experience

I have been fortunate to have held a number of leadership positions over the years, and when I look back, this actually started at an early age.  I don’t think we tend to look back as far as our school years, but I have thought about this a lot since I started a role with the NHS Leadership Academy in 2021.  Roles such as captaining sports teams, head students, and class representatives can all help instil leadership values from a young age, but we may not recognise it as such at the time.  
 
I always knew I had the drive to be part of a team and initiatives that help and support people, whether that be on an individual basis or part of a collective.  So, alongside applying for more senior NHS clinical management-type roles that had elements of leadership in them, I also took on voluntary roles to help broaden my perspectives and experiences.  This included work with membership bodies, hospices, charities, humanitarian organisations, both in the UK and globally and something that has been fundamental to my leadership journey. 

What helped you develop as a leader?

For me, as a white, British-born female, embarking on an inclusive leadership journey was a choice.  I now know that I have been afforded opportunities just because of who I am, and that didn’t sit right with me as I progressed into more senior leadership roles.  After a very open and honest conversation with a mentor at the time, it exposed the conscious and unconscious bias that I had.  It was a moment in my leadership journey I will never forget, as it opened my eyes to the systemic discrimination people face because of who they are and what they are not.  It also made me question how people like me can either enable this discrimination or be part of a movement for change. 

What makes a good leadership training experience?

Having worked in a more formal leadership role as Head of Clinical Leadership Development with the NHS Leadership Academy, I look at this question from different perspectives.  For those who prefer a more academic or taught leadership programme, the best ones actually facilitate people to understand themselves as a leader. They encourage people to hold up the leadership mirror and ask themselves what values they hold and how inclusive they are.  They don’t dictate what leadership styles they should and shouldn’t adopt; they encourage people to be curious and understand the importance of how leadership feels, not looks.  

Whether your leadership journey is part of a programme or self-discovery, compassion is something that should become embedded in everything we do, not just with patients but with ourselves and our colleagues.  Acknowledging the power in forming trusted relationships and understanding why trust can be more difficult for some, especially those who have experienced poor behaviours in the past.

Inclusion and belonging should be the golden thread in any healthcare leadership programme and journeys with a focus on inequalities, anti-racism, and eradicating all forms of discrimination we see across not only the NHS but also in society as a whole.  If we don’t develop inclusive leaders, discrimination will always be enabled by people and systems. 

What qualities do you feel are important in leadership roles?
 
I feel this is about having a deep understanding of self and the values you hold.  Only when we understand ourselves and have been on our own leadership journeys can we support and empower others.  More often than not in healthcare, people are given positions of ‘leadership’ when they are management roles for which people have rarely had adequate training.  This is especially true for clinicians, so it is important to understand the difference between leadership skills and management abilities. 

My own personal values include honesty, respect, compassion, integrity, and authenticity. For me, that enables open communication, makes me approachable and empathetic, allows me to build trusted relationships, and creates inclusive cultures where people feel they belong. 

I also feel we should encourage individuality.  Not all people will lead in the same way, so it’s about developing an understanding of each other, which can be very difficult to do in busy, stressful and hectic work environments.  That is why it is imperative for people to have the time and space to develop working relationships, and as leaders, it is part of our responsibility to enable this.

What are the barriers and what helps?

If we think about leadership as a journey, one of the biggest limitations for people to embark on this journey is themselves.  As I mentioned earlier, some people with societal privilege will automatically be afforded opportunities that will enable their career and help them climb the ladder.  This does not mean they don’t have to work hard to get there, it means they might only support others who they have affinity with or who they can relate to when they are in positions of responsibility and power.  

Having diverse mentors can really help you understand your own conscious and unconscious biases as well as helping you to identify specific areas to focus on for your own leadership development.  For me really looking at my circle of colleagues and friends was a huge aspect of this.  If you don’t have diversity in your conversations and who you have them with, there won't be diversity in your thoughts and beliefs, and that can be very limiting as an inclusive leader and very damaging for people around you. 

Finally, I think of my leadership journey as continuous and taking every opportunity I can to diversify my thoughts and experiences.  This could be something as simple as a cup of coffee with someone I would not normally have had the opportunity to talk with, or making a deliberate effort to attend events or talks that I would not usually go to, as it really encourages me to continue to grow as an inclusive leader.